3

On the Road to Embryo Transfer

Has it really been a month since my last post? I could be cliche and say time flies when you’re having fun, but honestly the past month has been dragging by. I just haven’t been able to bring myself to write lately, but since we are officially on the schedule for our frozen embryo transfer it is time.

I was disappointed when our fresh transfer was canceled, but I know it was for the best. My estrogen levels were too high and I was too high risk for OHSS (ovarian hyper stimulation syndrome). That doesn’t make it easier, as I’m not a fan of change… to say the least. Dr. Dunaway did reassure me that their statistics are very good for FETs (frozen embryo transfers). 37 of the past 42 have been successful.

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So what have we been up to on the fertility journey this last month? To start, I’ve been on birth control for five weeks, today was my last pill. I’ve explained why many IVF/FET protocols include birth control in the beginning in previous posts, but it basically allows your hormones to start at a baseline and gives the team as much control as possible.

I have the opportunity to experience LUPRON again… my favorite.

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Lupron stops estrogen production. Makes it tank. Out of no where… BOOM.. I’m a 26 year old experiencing menopause symptoms. I can’t sleep, I have hot flashes, headaches, and I’m all around miserable. To be fair, I already eat dinner 430pm and go to bed by 9. They should just go ahead and give me that senior discount.  I will say that as hard as it is to get out of bed at 430am, I do feel immensely better after going to the gym. I had stopped going for my entire retrieval cycle but I’m going to try and keep it up this time.

On Tuesday I had my baseline ultrasound aka a morning date with the dildo cam, along with bloodwork. On the ultrasound they were able to confirm that I had no cysts, but still have some hemorrhaging leftover from the retrieval, but since my ovaries have done their jobs, that won’t hold us back for the FET. Blood work also checked out, so that means we’ve checked the next box.

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The following day I went back to the Fertility Institute for my 21st appointment – the endometrial scratch. Fertility clinics only started offering endometrial scratching recently. Research is still ongoing. But it’s already one of the more accepted add-on treatments. Compared to the evidence on fashionable extras like embryo glue and intralipids, endometrial scratching has more kudos.

Best described as being similar to a smear test, an endometrial scratch involves a quick scrape of your womb lining at a certain point in your cycle by inserting a catheter into the uterus through the cervix. The promising research suggests it could improve embryo implantation, especially if you’ve had failed IVF attempts before.

How does it work? Well, endometrial scratching seems to provoke a reaction within the inner lining of the womb. Hormones and chemicals are released to help the lining repair itself. A genetic trigger response to an endometrial scratch may give the implantation ‘green light’. In essence, the temporary injury seems to make the endometrium more receptive to an embryo. That means a better chance of a pregnancy and a live birth.

Early studies into endometrial scratching have brought intriguing results, gaining the attention of infertility experts. A 2012 study found that having an endometrial scratch was 70% more likely to result in pregnancy in women with unexplained recurrent implantation failure. And researchers in 2015 concluded that endometrial scratching was more likely to improve the birth rate for women with two or more previous IVF failures. It is in the standard FET protocol for Dr. Dunaway.

Basically, he goes all Freddy Krueger up in that joint.

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It’s lovely. And by lovely of course I meaning I NEVER WANT TO DO IT AGAIN. The scratch itself wasn’t that bad. You’re instructed to go in with a full bladder. Well, I underestimated the amount of time it would take for my bladder to fill, so by the time I got there it was really full.

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After getting undressed from the waist down, again, the procedure was conducted via ultrasound. But not the way I was used to. Nope, she threw that jelly on my abdomen and I had the pleasure of staring at my empty uterus. I had imagined the first time I had that ultrasound that we would be looking at our baby. Thanks for that.

Anyways, he prepped the cervix with iodine, which felt like a regular pap smear. Then came the catheter. Which would have been fine, except my uterus had two bends in it (maybe partially because I was about to pee myself… and on doc I suppose). He had to twist the catheter multiple times while it was inserted, took it out to bend it, and tried again. This happened not once, twice, but THREE times before he got to where he needed to be. I was seeing stars it hurt so badly. Thank goodness for the 1000mg of tylenol and 1000mg of ibuprofen I had popped.. after that the scratch felt like nothing.

So now… we wait. I’ll wait for hopefully my last period to come (hopefully I can tell, I’m still bleeding from the scratch and spotting from the lupron) and then I start estrogen patches and a new injection.

It is impossible to give an exact date, but I think our FET will be around June 20th. We will be transferring two embryos, with a 60-70% chance of pregnancy and 30% chance of that pregnancy being twins. If this cycle is successful, the due date would be March 7th.

Sending you all love and baby dust!

Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
Clomid: $9.60 ($100 without insurance)
IUI Payment #1: $880
hCG trigger: $125
IUI Payment #2: $485
IVF Consult: $100
IVF Workup #1: $350
IVF Workup #2: $205
Infectious Disease Testing: $92
IVF Payment #1: $7,600
IVF Medications: $1,344
IVF Workup Balance: $196
IVF Payment #2: $7,600 (IVF payments covered by Sarah’s Laughter giveaway)
Anesthesia: $550
FET Medications: $1,500
Endometrial Scratch: $110

TOTAL: $22,464

 

 

1

D-Day and the Ice Age

Happy Easter, y’all! D-Day (Egg Retrieval Day) has come and gone, and tomorrow is the Big Freeze. I am fortunate enough to be writing this from the beautiful Gulf Shores in Alabama.

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Sunrise on the beach this morning

The past week has honestly been a blur, and it is bittersweet to be on vacation, but truth be told I probably needed it. I’m even taking a few days off of work (what!?!) to stay until Tuesday. Well, I pulled the trigger (to “trigger” ovulation) at 2100 on Monday.

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Ovidrel was one of the easiest shots that I’ve taken

The egg retrieval was the most fun I never want to have again. The day before the retrieval was miserable. At that point my ovaries and follicles measured several inches across, and I could feel it. I could feel the heaviness and discomfort with every step, and every time I changed positions. And on top of that, I was showing “pregnancy symptoms” from the Ovidrel, which contained hCG.

Egg retrieval takes place 36-37 hours after the trigger. We got to the clinic and I got to change into my incredibly stylish gown, hair cover, and booties.

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Oh hey good lookin’

Come time for the procedure the anesthesiologist came and put in my IV (in the wrist, and yes, it hurt) and it felt like after that things started coming all too quickly. They had me walk to the back and lay on the table, and started strapping me in. It was maybe five seconds after that when the room started spinning. I’m fairly certain that I said something inappropriate and then I was out.

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I basically remember nothing else except vaguely driving home and waking up on the couch. Apparently I was quite entertaining on anesthesia. For some reason, I kept calling the eggs and potential babies “gerbils”. Lucky for y’all, my wonderful husband recorded everything.

For the most part I have felt okay. My heating pad was my best friend for the first two days. The only time I really had pain was when I would get up and push myself (I have a hard time just sitting still). In the future I’ll write another post with some tips on surviving the retrieval, but it went a lot more smoothly than I imagined.

So here’s the big news… the count!! Drumroll please….

14 Eggs Retrieved
12 Eggs Fertilized
8 High Grade Embryos, 2 Medium Grade, and 1 on watch

Y’all we have eight embryos for sure!!!

We are over the moon excited that we can move forward to the next step… tomorrow is the Big Freeze, and the start of the Ice Age for our little embies.

So now what? We wait. giphy

And wait… and wait…

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We will have a better timeline when my next cycle starts. Doc said it could be two weeks, it could be a month. We will see what my body does. Until then … we get to “relax”. Cheers to brewing up a baby!

 

0

What are the Odds?

Probability: noun likelihood of something happening

The past few days have been a whirlwind of emotions, ups and downs, and I promise that isn’t just the hormones talking. Where do I even start?

Let’s start with one of the most incredible things that has ever happened to us.

In previous posts I shared the Baby Steps Infertility Awareness Fun Run put on by Sarah’s Laughter. At the run we had 19 incredible members on our team on the day of the run and our friends and family helped us to raise just over $1,000 for Sarah’s Laughter. The event gave away a $500 grant, a $10,000 grant, and four free IVF cycles, one of which was donated by my clinic (Fertility Institute, Baton Rouge location – Dr. Dunaway).

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We had to represent Brieux Carre!

The names were read off and a Samantha was called – I think we were all holding our breath but let out a sigh of disappointment when the last name wasn’t ours. But on the last drawing.. it happened! He actually read our name! I wish that I could describe how it felt. I was in shock, disbelief, awe, and it felt as if my legs had given out. I nearly fell to my knees, but still had to walk to the front! Taylor practically carried me as we went up. I didn’t know if I would be able to make it. I’ve watched the video (https://www.facebook.com/jasonforbus/videos/10209162710248142/ at 7:40) several times, just to make sure it really happened, and I’ve cried every time. The cycle that we won was actually for our clinic! This means we are being refunded what was already paid, and do not have to pay anything additional.

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The amazing FINO team

We had a 1.46% chance of winning. Only 1.46%. But it happened. We are so overwhelmingly grateful for Sarah’s Laughter and the Fertility Institute. You are changing our lives, and we have our friends and family to thank for supporting us and putting our name in the drawing.

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I’m finally at the end of stimulation meds. It has certainly been a long, long, long nine days of stims. Luckily, after decreasing the dose of Lupron from 10 IU to 5 IU many of my symptoms eased up, primarily the insomnia and hot flashes, thank goodness. I started on 150 IU of Gonal-F and 75 units of Menopur until day 4, when I lowered by dose of Gonal-F to 100 IU per day. My mood has been something else though. I go from happy go lucky to ready to bury a body in 0.67 seconds. I figure that’s why my husband has been working until midnight every night and leaving before I wake up….
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Here are my final scan results:

Right Ovary:
(1) 20 mm
(1) 18 mm
(1) 16 mm
(1) 15 mm
(1) 14 mm
(2) 12 mm
(2) 9 mm
(1) 7 mm
(1) 6 mm
(1) 5 mm
12 total on right

Left Ovary:
(1) 22 mm
(2) 21 mm
(1) 19 mm
(2) 18 mm
(1) 14 mm
(1) 13 mm
(1) 11 mm
(1) 9 mm
(3) 8 mm
(1) 6 mm
14 total on left

26 follicles total! So everything looks great to move forward with retrieval on Wednesday. I have a LOT of discomfort. I can feel my ovaries with Every. Single. Step. Of course I have allergies right now, and when I sneeze, it feels like my ovaries are going to explode.

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My ovaries are so big I look pregnant already… what a tease!

Now that we’ve covered all of the good news, here’s the not so good news. When Jackie called me this afternoon to give me trigger instructions she also told me that Dr. Dunaway feels that I am very high risk for Ovarian Hyperstimulation Syndrome (OHSS), so they are canceling our fresh embryo transfer and freezing all of the embryos. OHSS happens when your ovaries overreact to the fertility drugs. They may quickly swell to several times their normal size, and can sometimes leak fluid into the abdomen. About one in three women have mild symptoms (hence my bloating), one in 25 experience moderate symptoms, and one in 100 experience severe symptoms. It can cause rapid weight gain (40 pounds in two days), vomiting, blood clots, and other symptoms.

I understand avoiding OHSS. I don’t want it. But when I was going through possible scenarios in my head of what could go wrong, this isn’t something that I had considered. It’s been so hard to not get excited for all of this, but every time we get to check one box I’m just more anxious for the next.

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I was devastated today when she told me that our transfer wouldn’t occur until the end of May or beginning of June. It’s just another change to the plan. I’m also terrified that our embryos (however many we have) won’t survive the freeze and thaw. I was heartbroken thinking of more probabilities. But then I think of our chances of winning the free IVF cycle. 1.46%. My chances of OHSS are higher than that. And our chances of a FET (frozen embryo transfer) being successful is WAY higher than that. So there is hope.

That means that we will continue to limp along down the infertility road a little longer.

But it’s the possibility that keeps me going, not the guarantee.

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Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
Clomid: $9.60 ($100 without insurance)
IUI Payment #1: $880
hCG trigger: $125
IUI Payment #2: $485
IVF Consult: $100
IVF Workup #1: $350
IVF Workup #2: $205
Infectious Disease Testing: $92
IVF Payment #1: $7,600
IVF Medications: $1,344
Sarah’s Laughter IVF Giveaway: ($7,600)
IVF Workup Balance: $196

TOTAL: $4,908

3

Expect the Unexpected

This roller coaster ride feels like a real world version of Big Brother. Every week we get the phone call from Jackie, the IVF nurse (ie Julie.. for my fellow BB junkies..), it seems like a new twist. Since we first decided to go the IVF route in January, the plan has been to do IVF in May.

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On Thursday, Jackie called and asked “do you want to move your cycle up to April? We can start you on birth control tonight.” And I froze. I was speechless. I called Taylor before giving the yes, and then we were on our way.

But the plan… the plan was May. If you know me personally, you know that I am a type A, planning, regimented kind of person who gets thrown off if the plan changes, or something big happens. Even if the change is good. So while I have the “Yay! We get to move up IVF and try for a baby sooner!”, at the same time I’m thinking “Holy crap this was NOT what I was planning”.

So I had a little breakdown. It was almost a year ago exactly that we found out that we had a 1 in 200,000 chance of conceiving naturally, and all of those feelings resurfaced after our plan was set in motion.

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But… I feel better now. Today is day four of birth control, and I’m not going to lie, I’m not feeling great on it. It’s been a while since I was on the birth control pill, and I think it’s throwing me off emotionally. I know that as we’re about to start this (only 11 days until stims) I’m bound to feel a little emotional, but I feel SO down. Antisocial. it’s like there’s a huge weight sitting on top of me that I can’t quite get off. But it’s fine. I’m sure this will be the least of my hormonal issues we start the cycle. My boss, who I’ve been open with about everything, joked that I should put a whiteboard on my office door and indicate my mood with a smiley face or a frowning face to warn people what they’re walking into. Thanks, boss! Though it’s not a bad idea since my usual face makes it hard to tell what kind of mood I’m in….

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But why birth control? It does seem counterintuitive, doesn’t it? First, it may help to understand how the egg development process works. Don’t get intimidated by this picture.

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The natural egg production cycle

During natural conception, several eggs begin to grow in both ovaries at the beginning of a cycle. Each egg grows inside of a structure called a “follicle”. Even in my ultrasounds now, I have many of these “resting follicles”, which is a good thing for us doing egg retrieval! A follicle basically looks like a small blister, about 3 to 4 mm in size, nestled on the surface of the ovary, containing follicular fluid and a tiny cell the size of a small grain of sand, which is the “oocyte”, or egg. The egg is to the follicle as a seed is to a fruit.

As a result of natural hormones (the body stimulates the ovary with a hormone called follicle stimulating hormone (FSH)), only one follicle is selected for ovulation and the rest are reabsorbed by the ovaries. The selected follicle grows to be about 20 mm in diameter, or about the size of a large grape, before rupturing and releasing the ovum (the fully developed oocyte). The ovum is swept into the fallopian tube and has roughly 24 hours to be fertilized.

There are three main reasons that most IVF protocols start with birth control.

  1. It gives the ovaries a little time to rest before they are stimulated. Let’s stick with the grape comparison. In a normal cycle, you have one grape on one ovary. For egg retrieval, I could have 10-15 “grapes” on each ovary.
  2. It allows the doctor to control the timing. There is only one embryologist and one RE at our clinic, so this allows them to control each cycle so that there are no conflicts in scheduling, and each woman can have her retrieval at precisely the right time.
  3. Birth control is shown to help reduce ovarian cysts. A cyst is a naturally occurring fluid filled sac on the ovary. With a freaking grape farm growing on each ovary, there is no leftover room for cysts.

 

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Ovarian cyst

Last Friday we both had our pre-IVF blood work and signed consent forms. Next Thursday, I will have a sonohysterogram. Sonohysterography is a special kind of ultrasound exam. Fluid is put into the uterus through the cervix using a thin plastic tube, and sound waves are then used to create images of the lining of the uterus. The fluid helps show more detail than when ultrasound is used alone. This will allow doc to check for any abnormalities since we are planning on doing a fresh transfer (unfrozen embryos, 5 days after retrieval).

But just for a second, can we talk about hope? Even now… I know there is a good chance that this will work. BUT… I don’t want to be too hopeful. There’s still a decent chance that it won’t work. Even still…. I can’t help thinking what if it does.

If it does…. and I stay on the projected schedule (I probably won’t ..things always change), our retrieval/conception day would be April 3. That means that the due date would be on Christmas. I cannot imagine a better Christmas gift. It’s impossible to not have those thoughts. But we’ve had these thoughts before, these hopeful thoughts, and we have been crushed each time.

But still … We have hope.

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Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
Clomid: $9.60 ($100 without insurance)
IUI Payment #1: $880
hCG trigger: $125
IUI Payment #2: $485
IVF Consult: $100
IVF Workup #1: $350
IVF Workup #2: $205

TOTAL: $3,276

 

 

0

Advocate: (verb) to openly support

Being a fertility advocate sucks sometimes. Don’t get me wrong, I am happy with the route we have chosen, being open about everything. But sometimes it’s hard. When we started this journey, I was exhausted. I was exhausted from the pain of trying to conceive. Exhausted from the failures month after month. Exhausted from the emotions.

I was tired of living under a cloud.

I didn’t want to be that person who didn’t go to baby showers because I couldn’t handle other people being happy. I couldn’t talk to people with primary infertility about my problems because they get mad and accuse me of being selfish, and ungrateful. I couldn’t talk to people who weren’t struggling with infertility because I was afraid of making them uncomfortable and stealing their joy. I was tired of being that person who was miserable in the mall during shopping trips because of all the happy glowing pregnant women.

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I was tired of being afraid to talk about our infertility.

But since being open, things are so much better. But… some things have been harder.

Our disappointments are not just ours to mourn

This one might be the hardest. There is so much hope in fertility treatments, but the reality is that nothing is guaranteed. So when something is unsuccessful, or you take a step back, there are so many people who grieve with you. The support is incredible, but at the same time you feel guilty having put people through the pain with you. You feel guilty that you can’t give them good news.

“Everyone has to walk on egg shells around you”

Yes, this is actually something that someone said to me. No less a woman that actually claimed to have been open about fertility herself. Part of being an advocate is when someone says something that is inappropriate, or insensitive, I will absolutely speak up. Ignorance on fertility and loss is overwhelmingly prevalent. So when someone complains to me about being pregnant, and “losing their body”, or that they’ve had more practice looking at sonograms, yes… I’m basically going to tell you to stop being a dick.

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So no, you don’t have to walk on eggshells, but maybe you should rethink the way you think about fertility, because since one in eight couples face infertility, I guarantee I’m not the only one you’ve been insensitive to.

Fertility treatments feel as if they take a lifetime

I really wish that when we talked to people about our path forward that we had news to share. The reality is that fertility treatments move SO SLOWLY. Seriously. At the speed of government.

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You can only try something once a month. If that. That means if you’re lucky, you get maybe 10-12 tries a year. Unless it’s something like IVF, which is closer to 4 or 5 tries a year (if you can emotionally handle it).

But really. Whoever said patience is a virtue has clearly never had the two week wait after a fertility treatment.

IVF is selfish and morally wrong

Yes, this is something I actually had said to me. And if you know me at all you can pretty much envision how it went.

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Some people are very judgmental about infertility treatment, and some even oppose it on religious or moral grounds. Many of these folks are self-righteous and not above judging someone who avails themselves of modern fertility treatments. This is life and I’ve had to just let those people go.

Thank You

And this. This is why it’s worth it. Infertility is nothing to be ashamed of and continued silence lends the impression that there is.  We all need to talk about infertility to remove the stigma. More people than you can imagine have experienced or are experiencing infertility. You won’t find out about them unless you let people know you are infertile. You may be a blessing in someone else’s life by letting them know what you are going through.

Being open about infertility, allows others to be open about their struggles in other areas with you. Once people understand that you’ve experienced great pain in your life, they may feel comfortable talking with you about their life pains. And we all need support.

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On April 8th, 2017, Sarah’s Laughter will be hosting the Baby Steps Fun Run.

Brewing up a Baby will have a team! At this fun run, they will be giving away FOUR (yes… FOUR) free IVF cycles and a $10,000 fertility grant. Most people know that IVF is a huge financial burden, and this is an amazing opportunity for five couples to have.

For each team member running, the team will get one ticket in the drawing, and for every $250 raised in the fundraiser, the team will get ten tickets in the drawing!

CLICK HERE TO JOIN OUR TEAM

If you cannot run with us… CLICK HERE TO DONATE

Our team name is Brewing up a Baby  – Baby Pellerin

 

2

What is IVF?

Hello world. Last we spoke, Taylor and I had just had our IVF consult. If you know me at all, you know that I’m pretty OCD about clutter and cleanliness, and I’m especially anal about anything sitting on the kitchen counter. Well after we got home, I let that IVF packet sit on the counter for almost a month. A MONTH.

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I agree, Monica

But last week I finally felt ready to bring the feels back on. I seriously cannot stress enough that infertility is a constant roller coaster of emotions. Right when you think you’re okay and have accepted things.. BAM! It hits you across the temple like a bag of bricks.

I have gotten quite a few questions on what IVF actually is, so I figured I would make this blog post to bring everyone up to speed. Ready for IVF 101?

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Of course I had to throw in a Disney reference…

How did IVF come to be? (this is the boring part, so unless you’re a science/history nerd like me, you may want to skim over)

Although IVF has only recently been widely used to treat infertility problems, people have been seeking medical help to overcome reproductive barriers for a long time.

In 1884, the first known artificial insemination using donated sperm took place—and the woman inseminated did not even know what had happened. A couple having fertility problems were examined by Dr. William Pancoast of the Jefferson Medical College in Philadelphia. After finding that it was the husband’s sperm that was the problem, and the woman’s reproductive system was fine, the doctor realized their fertility problems could be solved using donated sperm through artificial insemination. This had not been done in humans previously, and such an idea at the time would have been rather scandalous, possibly even considered to be an act of adultery.

Consequently, the woman, and most likely the husband as well, were not told what was causing the fertility problems, or what the “treatment” would be. She was told only to return for a follow-up appointment to have “her” fertility problems fixed. When she arrived, she was knocked out with chloroform and the doctor chose a sperm donor from his medical students that were present. The student masturbated into a cup and the semen was injected into the unconscious woman’s uterus. It was successful: Nine months later she gave birth to a baby boy, still not knowing how she became pregnant.

Not until the 1930s did the idea of artificial insemination receive much publicity. During the 1940s, researchers found how to successfully freeze donated sperm, which led to many sperm banks opening in the 1970s. However, artificial insemination is only beneficial when the infertility of a couple is due to the “male factor.” If the woman is having reproductive problems, the situation can be much more difficult to solve, although this was greatly helped with the development of pregnancy-stimulating hormones in the 1960s. However, because such drugs can only help so much, the arrival of IVF revolutionized the existing field of assisted reproductive technology.

Like all science, IVF didn’t come out of nowhere; researchers had been performing the studies that enabled the development of IVF for around half a century. In England in 1890, Walter Heape transferred embryos from one rabbit to the reproductive tract of another rabbit, and successfully had the recipient rabbit give birth to offspring using this method. For decades, more animal studies built upon Heape’s original findings.

But scientific research cannot progress without the proper tools. Techniques for culturing cells improved during the 1960s and 1970s and, together with a better understanding of the hormones released during pregnancy, this allowed researchers to eventually culture embryos outside of the human body.

In 1978, the first person was born from IVF. Lesley and John Brown had been trying for nine years to have a child, but one of Lesley’s fallopian tubes was blocked and consequently her eggs could not travel down to the uterus to be fertilized. On their mission to have their own biological child, Mr. and Mrs. Brown met Drs. Robert Edwards and Patrick Steptoe, who had been working on IVF treatments. Previous couples had tried IVF, but none of the treatments resulted in successful pregnancies. However, the IVF treatment worked for the Browns and on July 25th, 1978, Louise Brown was born.

So what exactly is IVF? (In case you were sleeping, this is back to the good stuff)

IVF is terrible. It most definitely falls into that category “What doesn’t kill you makes you stronger.” It hurts more than you think it will. And it lasts far longer than it should. When it does not work, it feels a punch in the gut combined with the unexpected death of your childhood pet.

But, but, but….when it does work, it is nothing short of a miracle.

IVF is usually your last stop at the end of a long journey. You have probably spent years trying to get pregnant every which way. Nothing has worked. And that’s what finds you at a fertility clinic staring at a Reproductive Endocrinologist (RE), trying not to cry.

In essence, in IVF sperm and eggs are removed (sometimes from donors) and fertilized outside of the body (in a Petri dish) and then implanted back into a woman’s uterus. (The term “in vitro” literally means “within the glass” in Latin and is often applied to the study of a normal biological process replicated outside of an animal. In the case of IVF it is a bit misleading as the embryos are not placed in a glass tube, but in a plastic Petri dish.)

One treatment, or “cycle” of IVF, takes about four to six weeks from start to finish. Before the eggs can even be removed from the woman, her ovulation cycle is strictly regulated using drugs that first prevent ovulation (for two weeks) and then drugs that stimulate ovulation (for about ten days). This is achieved with injected medications, and this phase is called “stimulation”, or “stim”. This helps ensure that she will have a large number of eggs ready to be harvested at a given time.During this time, you will be closely monitored. That means bloodwork and ultrasound either every day or every other day. It’s a huge time commitment. The only slight positive is that it is kinda cool watching your follicles grow slowly day by day. (You are aiming for them to get over 18mm.) About 34 to 40 hours before the eggs are to be harvested, the woman is given a final drug to “ripen” the eggs.

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IVF Medications

When the big day arrives, you go to the center, and are put to gentle twilight sleep, while your doctor makes tiny incisions through your ovaries, or uses a needle through the pelvic floor, and individually takes out the eggs. When you stop and think about it – it is pretty damn cool. You wake up cramping and slightly unhappy. Your recently liberated eggs are whisked off to meet your partner’s or donor’s sperm.

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Fertilization with ICSI (intercytoplasmic sperm injection), where the sperm is injected directly into the egg for better fertilization chances

Three to five days later, they are put back into you, all fertilized and ready to implant.

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Fertilized egg, now an “oocyte” progression

Only a few days after the eggs are removed, the best embryos are selected to be implanted; the embryos have about eight cells at this point. A thin catheter is used to insert the embryos, usually one or two, back into the uterus. (This is easier than removing the eggs; no anesthetic is used.) Two weeks after implantation, the woman undergoes a pregnancy test; if it is positive, the pregnancy should progress normally.

Anyway….

From this point on, it’s all a numbers game.

How many eggs did they harvest? How many were mature? How many fertilized? How many lived past the first day? How many have divided enough to plant back in you after 3 to 7 days? How many managed to implant after 14 days?

You can just imagine how nerve-racking each step of this process is. How each step lends itself to failure. They could harvest 10 eggs, and none will be mature. You could have 5 mature eggs and none will fertilize. You could have 3 perfectly fertilized eggs and none may implant. Or worst of all, you could go through all this, and get pregnant, only to miscarry a few short weeks later.

When they ask me what the worst part of thinking of IVF is – the cost? The time commitment? The pain? – I always say “No, no, no.”

The worst part of IVF is the uncertainty. It is the fact that you could go through all this trouble, sacrifice everything….and still not get a baby out of it.

Pursuing IVF treatment is a personal decision and there is no right or wrong – there is only what you feel, what you can endure, what you can sacrifice.

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I apologize that I have written a novel, but I hope that this post has been informational and enlightening to those wanting to know more about the subject. Taylor and I are slated to go through with IVF in May, meaning we will start treatment in April. We are so thankful for our friends and family, we could not do this without you all!

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Plans and Probabilities

Today was the day, our IVF consult. We have been looking forward to this for a month. Until last night. Last night the reality finally hit me of what we were going for. This morning when we arrived at the clinic my stomach dropped as if I had fallen off of a cliff.

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I know what you’re thinking. It was only the consult… but it just felt different. We knew the procedure. We had an idea of the cost. But going in and talking about it, seeing things on paper, and scheduling feels completely different.

Basically, the decision for us comes down to probabilities. With IUI, our probabilities after seeing our counts after the sperm wash were just too low for us to justify the cost, when that money could be going towards IVF where we have a great possibility. Dr. Dunaway thinks that with my age and my eggs, that our probability of success with transferring two embryos would be as high as 90%. So that’s what we will go with.

The soonest that our clinic can get us in is for the May cycle. That is much later than we were anticipating, but we are comfortable with Dr. Dunaway and trust his judgement. Now we start the process of evaluating the financial portion and what exactly we want to do. I’ll be doing another post soon explaining the IVF process.

So how am I feeling?

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Yep. That about sums it up. It will get better, it’s just an overwhelming amount of information. Are we ready? Yes and no. Personally I’m ready to have it over with. Honestly, thinking about all of the stresses that we have right now it’s probably best that we wait until May. Soon we will have our heads wrapped around all of this and we will be ready to move forward. Thank you all for your love and support. It’s impossible to go on this journey alone.

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Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
Clomid: $9.60 ($100 without insurance)
IUI Payment #1: $880
hCG trigger: $125
IUI Payment #2: $485
IVF Consult: $100

TOTAL: $2,721